Lung Diseases & Pulmonology

Covid19 Vaccine and Lung Immunopathology

As an expanded number of coronavirus vaccines enter human clinical trials, in addition to understanding their efficacy in preventing severe SARS-CoV-2-related disease, a key outcome that will be receiving outsized scrutiny will be whether these vaccines contribute to lung immunopathology upon natural viral infection. Since the emergence of life-threatening severe acute respiratory syndrome (SARS) almost 20 years ago and subsequently Middle East respiratory syndrome (MERS) in 2012, numerous vaccines have been developed and tested in experimental animals to combat these lethal coronavirus-associated respiratory syndromes. An unexpected and concerning feature of several of these is the appearance of lung immunopathology that is seen in animals receiving certain types of vaccines. This result is especially concerning given that vaccine associated enhanced respiratory disease (VAERD) was seen in human vaccine trials against the ubiquitous airway pathogen respiratory syncytial virus (RSV).